Time to integrate climate science into kidney care planning: a ‘PASIGE’ to a climate change mitigation and adaptation framework
File(s)
Published version
Author(s)
Sandal, Shaifali
Jha, Vivekanand
Type
Journal Article
Abstract
Purpose of review: Kidney diseases affect around 850 million people globally and are a growing public health burden, with high rates of associated cardiovascular mortality and no major decline in age-standardized mortality compared to other non-communicable diseases. Climate change is an inequitable driver of kidney diseases, and climate-related disasters can disrupt access to life-sustaining kidney replacement therapies. Conversely, the care of patients with kidney diseases contributes to greenhouse gas emissions, pollution, and generates large amounts of waste.
Recent findings: Environmentally sustainable kidney care planning is pursuing kidney care practices and innovations that minimize environmental harm while remaining patient-centered and cost-effective. An adaptation and mitigation framework (a structured approach to developing adaptation strategies, policies, and measures) to guide this is lacking.
Summary: We propose the ‘PASIGE’ framework to guide climate science integration in kidney care planning -> Prevent: approaches to prevent kidney disease, its progression to kidney failure, and complications; Adopt: sustainable lifestyle, practices and therapies; Screen: targeted population screening for early detection and identification of kidney disease; Innovate: technology, manufacturing, procurement, energy sources and transportation; Generate: sustainably powered and produced low-impact net zero waste kidney replacement therapies resilient to climate threats; and Enhance: patient engagement, care quality and system resiliency.
Recent findings: Environmentally sustainable kidney care planning is pursuing kidney care practices and innovations that minimize environmental harm while remaining patient-centered and cost-effective. An adaptation and mitigation framework (a structured approach to developing adaptation strategies, policies, and measures) to guide this is lacking.
Summary: We propose the ‘PASIGE’ framework to guide climate science integration in kidney care planning -> Prevent: approaches to prevent kidney disease, its progression to kidney failure, and complications; Adopt: sustainable lifestyle, practices and therapies; Screen: targeted population screening for early detection and identification of kidney disease; Innovate: technology, manufacturing, procurement, energy sources and transportation; Generate: sustainably powered and produced low-impact net zero waste kidney replacement therapies resilient to climate threats; and Enhance: patient engagement, care quality and system resiliency.
Date Issued
2025-11-01
Date Acceptance
2025-07-04
Citation
Current Opinion in Nephrology and Hypertension, 2025, 34 (6), pp.534-542
ISSN
1062-4821
Publisher
Lippincott, Williams & Wilkins
Start Page
534
End Page
542
Journal / Book Title
Current Opinion in Nephrology and Hypertension
Volume
34
Issue
6
Copyright Statement
Copyright © 2025, Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
10.1097/MNH.0000000000001109
Subjects
adaptation
climate change
disaster management
disaster preparedness
disaster recovery
disaster response
framework method
frameworks
mitigation
nephrology
sustainable kidney care
Publication Status
Published